Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | G28911 | CA |
Y | 207VX0201X | Gynecologic Oncologist | G28911 | CA |
NPI | 1548286511 |
---|---|
Provider Name | William Max Rich |
First Address | Fresno, CA 93721-1431 |
Second Address | Fresno, CA 93710-5282 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 02/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G289110 | (05) | CA |
00G289111 | (05) | CA |
A43910 | (02) | CA |